Volume 03 Issue 02 Jul-Sep 2010
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 In EPA & DHA Research
Key Points
  • A range of chronic heart disease biomarkers were studied over a 3-year period in a population of Yup’ik Inuits in Alaska.  This community traditionally has a high intake of marine lipids.
  • The mean daily intake of EPA and DHA is 3.7g and 2.4g for men and women respectively; current European Food Safety Authority (EFSA) recommendations are 0.25g per day for adults.
  • With these high intake levels of EPA and DHA, there remained a strong correlation of improved biomarker status.
  • This study suggests that setting maximum intake recommendations at low levels may be unwise. 
Review Author:  Robert J. Winwood, PhD
Peer Reviewers: 

Mark Cope, PhD
Harry Rice, PhD 
Quarterly Journal of Significant Omega-3 Research
Yup'ik Inuit ceremony
Reduction in Chronic Disease biomarkers and very high intake of EPA and DHA omega-3 fatty acids

Review of:
Makhoul Z, Kristal AR, et al.Associations of very high intakes of eicosapentaenoic and docosahexaenoic acids with biomarkers of chronic disease risk among Yup’ik Eskimos. Am J Clinical Nutrition, 2010;91:777-785.

Brief Description

The Yup’ik Inuit people of Alaska have a much lower prevalence of cardiovascular disease and diabetes than most people in the world.  Their diet includes very high levels of marine omega 3 fatty acids, specifically EPA and DHA.  Their mean intake of EPA and DHA at 3.7g/day in men and 2.4g/day in women is over twenty times greater than the current daily mean of the US population at 0.14g in men and 0.09g in women. This was an extensive, longitudinal study of 357 Yup’ik people assessing  red blood cell (RBC) EPA and DHA levels with a wide range of chronic cardiac disease biomarkers conducted over 3 years. This is the first study of its kind involving such a wide range of EPA and DHA intakes.
The mean RBC EPA and DHA levels in the study were 2.8% and 6.8%, respectively. The association between EPA and DHA intake and beneficial biomarkers continued to improve as consumption increased.  The implication here is that much higher intakes of EPA/DHA will result in strong beneficial effects on chronic cardiovascular disease and diabetes.  Results were consistent with previous studies in that associations of EPA and DHA were inverse and linear for triglycerides and positive and linear for HDL cholesterol and apolipoprotein A-I.  The association with C-reactive protein was negative but non-linear; the association was much stronger when the EPA and DHA RBC levels exceeded 3% and 7 %, respectively, of the total fatty acid content. 

  • It is the first study to associate an extensive range of chronic cardiovascular disease biomarkers with EPA/DHA consumption over a very wide range of EPA/DHA consumption.
  • The associations were confirmed by sophisticated statistical modeling techniques.
  • The sample size was relatively small.
  • Supplementing the general population with EPA/DHA to the levels consumed by the Yup’ik population may prove impractical.
  • Biomarkers relating only to CVD and diabetes were used.
Implications & Application
This is an exciting study showing that cardiovascular benefits continue to improve at higher levels of intake.  For example, someone consuming 1.2g/d DHA to improve their brain and/or eye health will also make a significant improvement to their cardiac health.  The study also shows cause for concern with some regulatory authorities attempting to restrict maximum intake of DHA and EPA to much lower levels.

Suggested Citation

Winwood RJ, Cope MB, Rice HB. Reduction in Chronic Disease biomarkers and very high intake of EPA and DHA omega-3 fatty acids. Advances in EPA & DHA Research, vol 03;(02), 2010. 

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